What is the least likely complication associated with mandibular (lower jaw) splints: drooling, gingivitis (inflammation of the gums), pain of the Temporomandibular Joint (TMJ), malocclusion (abnormal bite) in the morning, or teeth migration?

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From the Guidelines

The least likely complication associated with mandibular splints is teeth migration. While mandibular splints can cause several side effects, permanent tooth movement is uncommon with properly designed and monitored splints 1. Some common side effects of mandibular splints include:

  • Drooling, which is common initially as the mouth adjusts to the foreign object
  • Gingivitis, which may occur if oral hygiene is poor while using the splint
  • TMJ pain, which can sometimes be exacerbated temporarily during adjustment periods
  • Morning malocclusion, where teeth don't align properly upon waking, is a frequent temporary effect as muscles and joints adjust overnight In contrast, teeth migration requires prolonged, consistent force application, which properly designed splints are specifically engineered to avoid 1. Dental professionals design these devices to distribute forces evenly and maintain proper occlusion, and regular follow-up appointments are important to ensure the splint continues to fit properly and isn't causing unintended tooth movement, which helps prevent all these potential side effects 1. A study published in the Journal of Clinical Sleep Medicine found that the use of oral appliances, including mandibular splints, can result in small but significant dental changes, such as a decrease in overbite and overjet, but these changes are typically not severe enough to cause teeth migration 1. Overall, while mandibular splints can cause some side effects, teeth migration is the least likely complication, and proper design, monitoring, and follow-up can help minimize the risk of all potential side effects 1.

From the Research

Complications Associated with Mandibular Splints

The potential complications associated with mandibular splints include:

  • Drooling
  • Gingivitis (inflammation of the gums)
  • Pain of the Temporomandibular Joint (TMJ)
  • Malocclusion (abnormal bite) in the morning
  • Teeth migration

Analysis of Complications

Based on the available evidence, the following can be inferred:

  • Gingivitis and malocclusion are potential complications associated with the use of mandibular splints 2, 3.
  • Pain of the TMJ is a common reason for prescribing a bite splint, and its occurrence as a complication is possible 2.
  • Teeth migration, also known as pathologic tooth migration, is a complication that can occur due to various factors, including periodontal bone loss and occlusal forces 4.
  • Drooling is not explicitly mentioned as a complication associated with mandibular splints in the available evidence.

Least Likely Complication

Given the available evidence, drooling appears to be the least likely complication associated with mandibular splints, as it is not mentioned in any of the studies 2, 3, 5, 4, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Use and abuse of bite splints.

Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995), 1999

Research

Pathologic tooth migration.

Journal of periodontology, 2005

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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